Objective: We aimed to explore the association between academic stress or motivation and the psychological well-being of medical students during the coronavirus disease-2019 (COVID-19) pandemic. We also explored the effects of their resilience or viral anxiety on this association. Methods: This online surveyed for medical students was done during October 20–28, 2021. Participants’ age, sex, grades, and COVID-19-related experiences were collected. Their symptoms were measured with Stress and Anxiety to Viral Epidemics-6 items, Medical Stress Scale (MSS), intrinsic motivation using Academic Motivation Scale, Connor Davidson Resilience Scale-2 items (CD-RISC2), the 5-item World Health Organization Well-Being Index (WHO-5), and GRIT scale. Results: Among 251 medical students, linear regression performed to explore the predicting factors for psychological well-being or medical stress showed that WHO-5 score was predicted by age (β=0.16, p=0.02) and CD-RISC2 (β=0.29, p<0.001) (F=15.5, p<0.001). In addition, the MSS score was predicted by age (β=0.20, p=0.004), intrinsic motivation (β=-0.31, p<0.001), GRIT (β=0.21, p=0.003), and CD-RISC2 (β=-0.31, p<0.001) (F=15.6, p<0.001). The resilience of medical students partially influenced their intrinsic motivation, affecting their psychological well-being or academic stress. However, no significant association was observed in the case of viral anxiety as a mediator, indicating that viral anxiety did not mediate the association. Conclusion This study highlights the importance of resilience in mediating the relationship between intrinsic motivation and psychological well-being or academic stress. However, viral anxiety was not found to be a mediator in this relationship.

Median raphe cyst (MRC) of the perineum is rare congenital midline cyst of the male genitalia. MRC is thought to be caused by congenital alterations in the embryologic development of the male genitalia during fetal life. MRC can be found on the midline position between the urethral meatus and the anus. The lesion can be cystic, but sometimes it looks like an elongated configuration called a raphe canal. Diagnosis in childhood is particularly rare because they are usually asymptomatic, but some cases have reportedly been identified after infection. Although conservative treatment can be possible in small asymptomatic lesions, the treatment of choice is simple excision followed by primary closure in symptomatic cases. We describe here the case of 2-year-old boy presented at our institution with a 10-month history of anomaly of the perineal median raphe, which was treated by surgical excision.
Anal Canal ; Child, Preschool* ; Diagnosis ; Genitalia, Male ; Humans ; Male* ; Perineum

PURPOSE: To evaluate the feasibility of comprehensive left ventricle (LV) functional parameters on routine coronary computed tomographic angiography (CCTA) based on two-dimensional echocardiography (2DE). MATERIALS AND METHODS: Ninety-nine patients who underwent CCTA accompanied by 2DE were included in the study. The volumetric LV systolic functional parameters were acquired from 10-phase reconstruction of CCTA data. By differentiating the time-LV volume curve by time domain and measuring mitral valvular orifice areas, transmitral time-velocity curves were drawn and the early (E) to late (A) mitral inflow peak velocities ratio (E/A ratio) was acquired. By measuring a longitudinal jerking velocity of the mitral valvular annulus on a four-chamber view, the mitral peak velocity of early filling (E) to early diastolic mitral annular velocity (E') ratio (E/E' ratio) was evaluated. All functional parameters were compared with the 2DE results. RESULTS: The LV end diastolic volume, LV end systolic volume, ejection fraction, stroke volume, cardiac output, and LV myocardial mass measured by CCTA and 2DE showed moderate to strong correlations (r = 0.732, 0.821, 0.416, 0.394, 0.328, and 0.764, respectively; p < 0.05). The E/A and E/E' ratios showed strong correlation between CCTA and echocardiography (r = 0.807 and 0.751, respectively; p < 0.05). CONCLUSION When CCTA is performed with retrospective electrocardiographic gating, additional information about the LV function can be acquired as reliably as with echocardiography.

No abstract available.
Cheek* ; Lymph Nodes* ; Skin*

Background: Whether depression before diagnosis of dyslipidemia is associated with higher cardiovascular disease (CVD) risk among newly diagnosed dyslipidemia patients is yet unclear. Methods: The study population consisted of 72,235 newly diagnosed dyslipidemia patients during 2003 to 2012 from the National Health Insurance Service–Health Screening Cohort of South Korea. Newly diagnosed dyslipidemia patients were then detected for pre-existing depression within 3 years before dyslipidemia diagnosis. Starting from 2 years after the diagnosis date, patients were followed up for CVD until 2015. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD were calculated by Cox proportional hazards regression. Results: Compared to dyslipidemia patients without depression, those with depression had higher risk for CVD (aHR, 1.24; 95% CI, 1.09 to 1.41). Similarly, pre-existing depression was associated with increased risk for stroke (aHR, 1.27; 95% CI, 1.06 to 1.53). The risk for CVD among depressed dyslipidemia patients for high (aHR, 1.42; 95% CI, 1.06 to 1.90), medium (aHR, 1.17; 95% CI, 0.91 to 1.52), and low (aHR, 1.25; 95% CI, 1.05 to 1.50) statin compliance patients tended to be increased compared to patients without pre-existing dyslipidemia. The risk-elevating effect of depression on CVD tended to be preserved regardless of subgroups of smoking, alcohol consumption, physical activity, and body mass index. Conclusion Dyslipidemia patients with pre-existing depression had increased risk for CVD. Future studies that determine CVD risk after management of depression among dyslipidemia patients are needed.

Background and Objectives: With the introduction of sialendoscopy, minimal invasive surgery has become possible for the removal of sialoliths, although sialendoscopic removal of parotid stones remains a surgical challenge. Sialendoscopic stone removal can be differently applied according to the location and size of stones. This study was conducted to evaluate the surgical outcomes of sialaendoscopic stone removal and to provide a strategy for choosing an adequate surgical approach according to the characteristics of parotid stones.Subjects and Method A retrospective study was conducted of 43 patients with parotid sialolithiasis who were treated by sialendoscopic stone removal between March 2017 and January 2021. Surgical techniques were classified into sialendoscopy alone (SA), sialendoscopy-assisted transoral approach (STO), and sialendoscopy-combined retroauricular approach (SRA). The parotid gland stones were categorized by size, location, and multiplicity. Results: Of the 43 patients, 13 patients underwent SA, 10 received STO, and 20 were treated with different SRA approaches. The SRA approaches included three distal, seven proximal, and ten intraglandular stone removal cases. The success rate of stone removal was 92% (12 cases) by SA, 90% (9 cases) by STO, and 100% (20 cases) by SRA. In cases of SA and STO, all patients had distant stones except for one who had proximal stones. Postoperative complications including pain, swelling, wound dehiscence, sialocele, duct stricture, and facial palsy mainly occurred in cases treated with SRAs. Conclusion Appropriate use of various sialendoscopy-assisted approaches is mandatory to preserve the gland and minimize surgical complications in patients with different features of parotid gland stones.

The association between lung injury and exposure to humidifier disinfectant (HD) containing a mixture of chloromethylisothiazolinone (CMIT) and methylisothiazolinone (MIT) has been controversial in South Korea. This study conducts a literature review in order to evaluate the likelihood of CMIT/MIT reaching the lower part of the respiratory tract and causing lung injury. A literature review focused on the inhalation risk of HD containing a mixture of CMIT and MIT. The major contents included the physicochemical properties of CMIT and MIT contained in HDs and methodological reviews on substance analysis, toxicity tests and clinical cases. HD products marketed in South Korea have been reported to contain approximately 1–2% CMIT and 0.2–0.6% MIT along with magnesium nitrate (20–25%), magnesium chloride (0.2–1.0%), and water (70–75%). The types of CMIT and MIT dispersed into the air and deposited in the respiratory tract are assumed to be either gaseous substances or nanoparticles mixed with magnesium salts. The result of the literature review including clinical cases of lung injury among CMIT/MIT HD product users, demonstrated that these chemicals likely reach the lower respiratory tract and accordingly cause lung injury.A number of humidifier disinfectant-associated lung injury cases with clinical evidence should be prioritized in risk assessment of HD containing CMIT and MIT, even though there might be insufficient evidence in all related areas, including inhalation exposure assessment studies, animal testing, and epidemiological studies.

PURPOSE: This study was designed to demonstrate the potential therapeutic advantage of 3-dimensional (3-D) treatment planning over the conventional 2-dimensional (2-D) approach in patients with carcinoma of the nasopharynx. MATERIAL AND METHODS: The two techniques were compared both qualitatively and quantitatively for the boost portion of the treatment (19.8 Gy of a total 70.2 Gy treatment schedule) in patient with T4. The comparisons between 2-D and 3-D plans were made using dose statistics, dose-volume histogram, tumor control probabilities, and normal tissue complication probabilities. RESULTS: The 3-D treatment planning improved the dose homogeneity in the planning target volume. In addition, it caused the mean dose of the planning target volume to increase by 15.2% over 2-D planning. The mean dose to normal structures such as the temporal lobe, brain stem, parotid gland, and temporomandibular joint was reduced with the 3-D plan. The probability of tumor control was increased by 6% with 3-D treatment planning compared to the 2-D planning, while the probability of normal tissue complication was reduced. CONCLUSION: This study demonstrated the potential advantage of increasing the tumor control by using 3-D planning, but prospective studies are required to define the true clinical benefit.
Brain Stem ; Humans ; Nasopharynx* ; Parotid Gland ; Temporal Lobe ; Temporomandibular Joint

9 and 10 years old boys presented with pain and swelling without history of trauma around medial malleolar right and left ankle. The swelling was diffuse with tenderness on anterior aspect of medial malleolus. The X-rays revealed fragmented accessory ossification center of medial malleolus an symptomatic side. Traction apophysitis was diagnosed because MRI revealed multiple foci of hypointensity in T1 and T2 weighted images of symptomatic medial malleolus apophysis. Patient was treated in conservative treatment by short leg cast for three or four weeks with restriction of sports activity and improved symptoms.
Animals ; Ankle ; Humans ; Leg ; Sports ; Traction

BACKGROUND: Liposuction and laser ablation for treatment of osmidrosis are leading treatment methods for osmidrosis and have less complication compare to conventional surgical method. We treated patients with the two methods simultaneously to maximize the efficiency for less complication. METHODS: Eighteen patients with axillary osmidrosis (total 36 axillae) were included in this study. They had been treated by liposuction with diode laser ablation from December 2011 to August 2012. The results of operation was assessed by questionnaire subjectively and microscopic study objectively. RESULTS: Eighteen patients were followed over 10 months postoperatively (range, 10 to 18 months; mean, 13.8 months). The patients were satisfied with their results in terms of reduced foul odor except one patient. No hematoma, infections, skin necrosis, hair loss or hypertrophic scar occurred. And there was quantitative reduction of apocrine glands in microscopic study. CONCLUSIONS: We suggest that simultaneous apply of liposuction with laser ablation which is clinically and histologically proven method for treatment of axillary osmidrosis could be more effective method than treatment with each method alone, and has same morbidity allowing the patients early exercise.
Apocrine Glands ; Cicatrix, Hypertrophic ; Hair ; Hematoma ; Humans ; Hyperhidrosis ; Laser Therapy ; Lasers, Semiconductor* ; Lipectomy* ; Methods ; Necrosis ; Odors ; Skin ; Surveys and Questionnaires